Real-time quantum error correction beyond break-even.

The ambition of harnessing the quantum for computation is at odds with the fundamental phenomenon of decoherence. The purpose of quantum error correction (QEC) is to counteract the natural tendency of a complex system to decohere. This cooperative process, which requires participation of multiple quantum and classical components, creates a special type of dissipation that removes the entropy caused by the errors faster than the rate at which these errors corrupt the stored quantum information. Previous experimental attempts to engineer such a process1-7 faced the generation of an excessive number of errors that overwhelmed the error-correcting capability of the process itself. Whether it is practically possible to utilize QEC for extending quantum coherence thus remains an open question. Here we answer it by demonstrating a fully stabilized and error-corrected logical qubit whose quantum coherence is substantially longer than that of all the imperfect quantum components involved in the QEC process, beating the best of them with a coherence gain of G = 2.27 ± 0.07. We achieve this performance by combining innovations in several domains including the fabrication of superconducting quantum circuits and model-free reinforcement learning.

Omics-driven utilization of wild relatives for empowering pre-breeding in pearl millet.

MAIN CONCLUSION: Pearl millet wild relatives harbour novel alleles which could be utilized to broaden genetic base of cultivated species. Genomics-informed pre-breeding is needed to speed up introgression from wild to cultivated gene pool in pearl millet. Rising episodes of intense biotic and abiotic stresses challenge pearl millet production globally. Wild relatives provide a wide spectrum of novel alleles which could address challenges posed by climate change. Pre-breeding holds potential to introgress novel diversity in genetically narrow cultivated Pennisetum glaucum from diverse gene pool. Practical utilization of gene pool diversity remained elusive due to genetic intricacies. Harnessing promising traits from wild pennisetum is limited by lack of information on underlying candidate genes/QTLs. Next-Generation Omics provide vast scope to speed up pre-breeding in pearl millet. Genomic resources generated out of draft genome sequence and improved genome assemblies can be employed to utilize gene bank accessions effectively. The article highlights genetic richness in pearl millet and its utilization with a focus on harnessing next-generation Omics to empower pre-breeding.

Signatures of Correlated Defects in an Ultraclean Wigner Crystal in the Extreme Quantum Limit.

Low-disorder two-dimensional electron systems in the presence of a strong, perpendicular magnetic field terminate at very small Landau level filling factors in a Wigner crystal (WC), where the electrons form an ordered array to minimize the Coulomb repulsion. The nature of this exotic, many-body, quantum phase is yet to be fully understood and experimentally revealed. Here we probe one of WC's most fundamental parameters, namely, the energy gap that determines its low-temperature conductivity, in record mobility, ultrahigh-purity, two-dimensional electrons confined to GaAs quantum wells. The WC domains in these samples contain ≃1000 electrons. The measured gaps are a factor of three larger than previously reported for lower quality samples, and agree remarkably well with values predicted for the lowest-energy, intrinsic, hypercorrelated bubble defects in a WC made of flux-electron composite fermions, rather than bare electrons. The agreement is particularly noteworthy, given that the calculations are done for disorder-free composite fermion WCs, and there are no adjustable parameters. The results reflect the exceptionally high quality of the samples, and suggest that composite fermion WCs are indeed more stable compared to their electron counterparts.

Highly Fluorescent ZnO Composite of N-doped Carbon Dots From Dregea Volubilis for Fluorometric Determination of Glucose in Biological Samples.

A nano-sensor based on N-doped carbon dots (NCDs)@ZnO (NCZ) composite was fabricated and efficacy for detecting glucose from human blood and urine samples in a straightforward manner was examined. The composite was prepared following a green hydrothermal method under ambient condition using a novel plant material, Dregea volubilis fruit and structural and optical properties were evaluated using standard techniques. The composite exhibited excellent characteristics including good photostability, biocompatibility, low toxicity, and strong fluorescence, with a decent quantum yield of up to 59%. The NCZ composite has been very sensitive and could selectively detect glucose in urine and blood samples. Selective glucose quenching was efficacious at different concentrations of glucose (1-6 mM) and in the pH range of 7-8, limit of detection was 0.25 mM. The potential uses of carbon-based materials have grown, thanks to the excellent sensing/detection capabilities of the NCZ composite as well as the capacity to prevent nanoparticle aggregation, opening up new possibilities for the development of environmentally benign nano-sensors.

Effect of duration of sodium valproate therapy on bone mineral density and vitamin D levels.

OBJECTIVE: This study aimed to evaluate the impact of prolonged sodium valproate use on bone mineral density (BMD) and Vitamin D levels in pediatric epilepsy patients. METHODS: In a cross-sectional study conducted at the Epilepsy Clinic of Niloufer Hospital, Hyderabad, India, 50 pediatric patients (aged 4-10 years) were recruited. The cohort comprised 30 epilepsy patients on sodium valproate treatment (cases) and 20 healthy siblings without epilepsy or valproate use (controls). BMD was assessed using dual-energy X-ray absorptiometry to measure height-adjusted total body less head Z-scores (TBLH Z-scores), and serum 25-hydroxyvitamin D levels were measured. Statistical analysis included independent samples t-tests, Mann-Whitney U tests, and Pearson correlation, with a preliminary power analysis ensuring adequate sample size. RESULTS: Cases exhibited significantly lower BMD TBLH Z-scores (Mean = -1.543) compared to controls (Mean = 0.515, p <.001) and reduced Vitamin D levels (Mean = 9.17 for cases vs. 27.80 for controls, p <.001). A negative correlation was observed between the duration of sodium valproate use and both BMD Z-scores (r = -0.626, p <.001) and Vitamin D levels (r = -0.707, p <.001). CONCLUSIONS: The findings suggest a significant negative impact of prolonged sodium valproate use on both bone density and Vitamin D levels in pediatric patients. These results underscore the importance of monitoring and managing bone health in children receiving long-term sodium valproate therapy.

CT-derived radiomics predict the growth rate of renal tumours in von Hippel-Lindau syndrome.

AIM: To predict renal tumour growth patterns in von Hippel-Lindau syndrome by utilising radiomic features to assist in developing personalised surveillance plans leading to better patient outcomes. MATERIALS AND METHODS: The study evaluated 78 renal tumours in 55 patients with histopathologically-confirmed clear cell renal cell carcinomas (ccRCCs), which were segmented and radiomics were extracted. Volumetric doubling time (VDT) classified the tumours into fast-growing (VDT <365 days) or slow-growing (VDT ≥365 days). Volumetric and diametric growth analyses were compared between the groups. Multiple logistic regression and random forest classifiers were used to select the best features and models based on their correlation and predictability of VDT. RESULTS: Fifty-five patients (mean age 42.2 ± 12.2 years, 27 men) with a mean time difference of 3.8 ± 2 years between the baseline and preoperative scans were studied. Twenty-five tumours were fast-growing (low VDT, i.e., <365 days), and 53 tumours were slow-growing (high VDT, i.e., ≥365 days). The median volumetric and diametric growth rates were 1.71 cm3/year and 0.31 cm/year. The best feature using univariate analysis was wavelet-HLL_glcm_ldmn (area under the receiver operating characteristic [ROC] curve [AUC] of 0.80, p<0.0001), and with the random forest classifier, it was log-sigma-0-5-mm-3D_glszm_ZonePercentage (AUC: 79). The AUC of the ROC curves using multiple logistic regression was 0.74, and with the random forest classifier was 0.73. CONCLUSION: Radiomic features correlated with VDT and were able to predict the growth pattern of renal tumours in patients with VHL syndrome.

Core and valence photoelectron spectroscopy of a series of substituted disulfides.

The valence and core photoelectron spectra of three substituted disulfide systems, α-lipoic acid, trans-4,5-dihydroxy-1,2-dithiane, and di-Boc-cystamine, are presented alongside detailed theoretical analysis based on equation-of-motion coupled-cluster singles doubles for ionization potentials and the nuclear ensemble approach. A comparison of the linear and five- and six-membered ring cyclic structures reveals that the energetic separation of the non-bonding sulfur orbitals can be used to calculate a reliable estimate of the C-S-S-C dihedral angle, even for substituted disulfides, and that the sulfur 2p, oxygen 1s, and valence band photoelectron spectra are a useful site-specific probe of hydrogen bonding.

Study of wave motion on the emergence of veering, locking, and coupling in periodic composite panels.

This research proposes the effect of micropolar-Cosserat (MC) parameters (length-scale parameters and Cosserat shear modulus) on the dispersion characteristics of propagating wave modes in periodic composite panels (PCPs). These inbuilt parameters are due to the assumption of the length-scale boundary conditions that allow for capturing the micro-rotational (MR) wave mode along with the flexural ones. A significant contribution of this study is the transformation of the two-dimensional (2-D) periodic composite problem into a series of one-dimensional (1-D) ones using the MC continuum theory. The analysis employs the transfer matrix method in the framework of the state-space approach to investigate periodic systems in the eigenvalue domain. Additionally, Bloch-Floquet's periodic boundary conditions (PBCs) are applied to the unit cell to ensure the periodicity of the system. The main innovation lies in observing veering, locking, and coupling phenomena, which occur due to alterations in lamina orientation and MC parameters. Moreover, the presence of inbuilt parameters renders the dispersion characteristics highly sensitive to even minor coefficient variations, with a mere 1% change significantly impacting eigenmode fluctuations. The sudden bandgap (BG) disappearing nature could be used to identify the accurate value of the coefficient for designing and analyzing PCPs.

The effect of the COVID-19 pandemic on the mental health of obstetrics and gynaecology trainees: a world-wide literature review.

BACKGROUND: Coronavirus (COVID-19) pandemic has affected the training and wellbeing of obstetrics and gynaecology (O&G) trainees. The aim of this review is to offer a worldwide overview on its' impact on the mental health of O&G trainees, so that measures can be put into place to better support trainees during the transition back to the 'new normal'. METHODS: Key search terms used on PubMed and Google Scholar databases include: mental health, COVID-19, O&G, trainees, residents. RESULTS: Fifteen articles (cumulative number of respondents = 3230) were identified, of which eight employed validated questionnaires (n = 1807 respondents), while non-validated questionnaires were used in seven (n = 1423 respondents). Studies showed that COVID-19 appeared to exert more of a negative impact on females and on senior trainees' mental health, while protective factors included marriage/partner and having had children. Validated and non-validated questionnaires suggested that trainees were exposed to high levels of anxiety and depression. Their mental health was also affected by insomnia, stress, burnout and fear of passing on the virus. DISCUSSION: This review analyses the global impact of COVID-19 on O&G trainees' mental health, showing a pervasive negative effect linked to fear of the virus. Limited psychological support has led to prolonged issues, hindering patient safety and increasing sick leave. The study underscores the urgency of comprehensive support, particularly in female-dominated fields. Addressing these challenges is crucial for future pandemics, highlighting the need to learn from past mistakes and prioritise mental health resources for trainee well-being during and beyond pandemics.

This review provides a worldwide overview of the impact Coronavirus (COVID-19) pandemic on the mental health of obstetrics and gynaecology (O&G) trainees. Fifteen articles were identified, of which eight employed validated questionnaires (n = 1807 respondents), while non-validated questionnaires were used in seven (n = 1423 respondents). The pandemic appeared to exert more of a negative impact on females and on senior trainees' mental health, while protective factors included marriage/partner and having had children. Studies suggested that trainees were exposed to high levels of anxiety and depression. Their mental health was also affected by insomnia, stress, burnout and fear of passing on the virus.Limited psychological support has led to prolonged recovery issues and increasing sick leave. The study underscores the urgency of comprehensive support, particularly in female-dominated fields. Addressing these challenges is crucial for future pandemics, highlighting the need to learn from past mistakes and prioritise mental health resources for trainee well-being.

A shared decision-making intervention for individuals living with chronic obstructive pulmonary disease who are considering the menu of pulmonary rehabilitation treatment options; a feasibility study.

OBJECTIVES: Shared Decision Making (SDM) has potential to support Pulmonary Rehabilitation (PR) decision-making when patients are offered a menu of centre- and home-based options. This study sought to evaluate the feasibility and acceptability of a three-component PR SDM intervention for individuals with Chronic Obstructive Pulmonary Disease (COPD) and PR healthcare professionals. METHODS: Participants were recruited from Dec 2021-Sep 2022. Healthcare professionals attended decision coaching training and used the consultation prompt during consultations. Individuals received the Patient Decision Aid (PtDA) at PR referral. Outcomes included recruitment capability, data completeness, intervention fidelity, and acceptability. Questionnaires assessed patient activation and decisional conflict pre and post-PR. Consultations were assessed using Observer OPTION-5. Optional interviews/focus groups were conducted. RESULTS: 13% of individuals [n = 31, 32% female, mean (SD) age 71.19 (7.50), median (IQR) MRC dyspnoea 3.50 (1.75)] and 100 % of healthcare professionals (n = 9, 78% female) were recruited. 28 (90.32%) of individuals completed all questionnaires. SDM was present in all consultations [standardised scores were mean (SD) = 36.97 (21.40)]. Six healthcare professionals and five individuals were interviewed. All felt consultations using the PtDA minimised healthcare professionals' bias of centre-based PR, increased individuals' self-awareness of their health, prompted consideration of how to improve it, and increased involvement in decision-making. DISCUSSION: Results indicate the study processes and SDM intervention is feasible and acceptable and can be delivered with fidelity when integrated into the PR pathway.

Biological wastewater treatment: a comprehensive sustainability analysis using life cycle assessment.

The research conducts a life cycle assessment (LCA) on wastewater treatment (WWT) methods-membrane bioreactor (MBR), soil biotechnology (SBT), and bio-electrochemical constructed wetlands (BCW)-in comparison with the conventional activated sludge process (ASP). Employing SimaPro v9.5 with a cradle-to-gate system boundary, the analysis utilizes the IMPACT 2002 + method, employing per cubic meter of treated wastewater as the functional unit. The analysis shows that SBT exhibits the lowest environmental impacts among the considered WWT methods. The global warming potential was 0.0996 kg CO2 eq. for SBT, 1.33 kg CO2 eq. for MBR, 0.131 kg CO2 eq. for BCW, and 0.544 kg CO2 eq. for ASP. BCW demonstrates a 75.91% decrease, while MBR exhibits a 144.48% increase compared to ASP. Notably, electricity consumption emerges as the primary contributor to environmental impact in MBR and ASP. The resource impact category varies with a 138.15% increase in MBR and an 83.41% decrease in SBT compared to ASP. Additionally, the research indicates that the high human health impact observed in MBR results mainly from increased carcinogens (0.00176 kg C2H3Cl eq.), non-carcinogens (0.01 kg C2H3Cl eq.), and ionizing radiation (3.34 Bq C-14 eq.). The findings underscore the importance of considering treatment efficiency and broader environmental implications in selecting WWT methods. As the world emphasizes sustainability, such LCA studies provide valuable insights for making informed decisions in wastewater management.

Phenotypic and genetic characterization of unexplored, potential cattle population of Madhya Pradesh.

Bawri or Garri, a non-descript cattle population managed under an extensive system in Madhya Pradesh state of India, was identified and characterized both genetically and phenotypically to check whether or not it can be recognised as a breed. The cattle have white and gray colour and are medium sized with 122.5 ± 7.5 cm and 109.45 ± 0.39 cm height at withers in male and female, respectively. Double-digest restriction site associated DNA (ddRAD) sequencing was employed to identify ascertainment bias free SNPs representing the entire genome cost effectively; resulting in calling 1,156,650 high quality SNPs. Observed homozygosity was 0.76, indicating Bawri as a quite unique population. However, the inbreeding coefficient was 0.025, indicating lack of selection. SNPs found here can be used in GWAS and genetic evaluation programs. Considering the uniqueness of Bawri cattle, it can be registered as a breed for its better genetic management.

Clinical and Epidemiological Characteristics of Mpox Cases Identified Through Case-based Surveillance in India, July 2022-January 2023.

BACKGROUND: Of the 43 mpox cases reported by the WHO in South East Asia between January 2022 and March 2023, 24 (56%) were from India. OBJECTIVES: We describe the clinical and epidemiological profile of cases identified through India's hospital case-based surveillance. MATERIALS AND METHODS: We identified mpox cases as a positive result for mpox virus polymerase-chain-reaction assay, reported through surveillance from July 1, 2022 to January 7, 2023. Cases and clinicians were interviewed, and data were abstracted from the medical records. We conducted contact tracing among family, close social networks, and healthcare personnel staff for the first 17 cases. We collected the data on sociodemographics, clinical findings, and behavior, and described data using summary statistics. RESULTS: We identified 24 laboratory-confirmed cases (42% females, median age 30 years, range 22-38), including one death (case fatality rate 4.2%). We collected clinical and behavioural data from 21 of 24 cases. All had rashes with vesicles and genital lesions; 7 (33%) reported genital lesions as the first symptom; and 3 (13%) reported complications. Among the 21 cases, all were sexually active, none self-identified as men having sex with men (MSM), and 6 (29%) reported multiple sex partners. We identified 51 contacts of the first 17 reported cases, none reported symptoms suggestive of mpox. CONCLUSION: The clinical and behavioral characteristics of mpox cases in India are consistent with the global 2022 outbreak, with the exception that no cases in India reported MSM. Most were sexually active young adult economic migrants and developed genital lesions.

Prevalence of Refractive Error and Spectacle Compliance in Children of Tokha Municipality.

Background Refractive error is considered as an important component of the priority disease "childhood blindness" within the Vision 2020' initiative to eliminate avoidable blindness. The large majority of vision impairment in school aged children is due to uncorrected refractive error. Hence, refractive errors are considered as a public health challenge. The aim of this study was to estimate the prevalence of refractive error and spectacle compliance among children in Tokha municipality, Kathmandu. Objective The aim of this study was to estimate the prevalence of refractive error and spectacle compliance among children from Tokha municipality, Kathmandu. Method A descriptive, cross-sectional study was conducted by enrolling 1366 children from Tokha municipality from 1st to 3rd week of April 2022 after obtaining the Institutional Review Board (Reference number:60/2079/80). Assent was taken from all children and informed consent was signed by the legal guardians of the children. All the samples underwent a comprehensive ocular history taking, visual acuity and refraction and ocular health assessments. The inclusion criteria was school going children within age group 5-16 years. Result Out of a total of 1366 samples, 10.91% (149) of the school children were identified to have refractive error. The primary type of refractive error observed was compound myopic astigmatism, which accounted for 52.3% (78) of the cases. A spectacle compliance rate of 72.15% was found. Conclusion Refractive error prevalence in this study is consistent with findings from other part of Nepal. The most common type of refractive error was compound myopic astigmatism. The frequency of refractive errors was notably higher among individuals who frequently use electronic devices, attend private schools, and reside in densely populated areas. It is recommended to organize regular community eye camps and conduct vision screenings to identify and promptly address refractive errors in children.

Fractional Quantum Hall State at Filling Factor ν=1/4 in Ultra-High-Quality GaAs Two-Dimensional Hole Systems.

Single-component fractional quantum Hall states (FQHSs) at even-denominator filling factors may host non-Abelian quasiparticles that are considered to be building blocks of topological quantum computers. Such states, however, are rarely observed in the lowest-energy Landau level, namely at filling factors ν<1. Here, we report evidence for an even-denominator FQHS at ν=1/4 in ultra-high-quality two-dimensional hole systems confined to modulation-doped GaAs quantum wells. We observe a deep minimum in the longitudinal resistance at ν=1/4, superimposed on a highly insulating background, suggesting a close competition between the ν=1/4 FQHS and the magnetic-field-induced, pinned Wigner solid states. Our experimental observations are consistent with the very recent theoretical calculations that predict that substantial Landau level mixing, caused by the large hole effective mass, can induce composite fermion pairing and lead to a non-Abelian FQHS at ν=1/4. Our results demonstrate that Landau level mixing can provide a very potent means for tuning the interaction between composite fermions and creating new non-Abelian FQHSs.

Valley-Tunable Even-Denominator Fractional Quantum Hall State in the Lowest Landau Level of an Anisotropic System.

Fractional quantum Hall states (FQHSs) at even-denominator Landau level filling factors (ν) are of prime interest as they are predicted to host exotic, topological states of matter. We report here the observation of a FQHS at ν=1/2 in a two-dimensional electron system of exceptionally high quality, confined to a wide AlAs quantum well, where the electrons can occupy multiple conduction-band valleys with an anisotropic effective mass. The anisotropy and multivalley degree of freedom offer an unprecedented tunability of the ν=1/2 FQHS as we can control both the valley occupancy via the application of in-plane strain, and the ratio between the strengths of the short- and long-range Coulomb interaction by tilting the sample in the magnetic field to change the electron charge distribution. Thanks to this tunability, we observe phase transitions from a compressible Fermi liquid to an incompressible FQHS and then to an insulating phase as a function of tilt angle. We find that this evolution and the energy gap of the ν=1/2 FQHS depend strongly on valley occupancy.

Effect of managed transition on mental health outcomes for young people at the child-adult mental health service boundary: a randomised clinical trial.

BACKGROUND: Poor transition planning contributes to discontinuity of care at the child-adult mental health service boundary (SB), adversely affecting mental health outcomes in young people (YP). The aim of the study was to determine whether managed transition (MT) improves mental health outcomes of YP reaching the child/adolescent mental health service (CAMHS) boundary compared with usual care (UC). METHODS: A two-arm cluster-randomised trial (ISRCTN83240263 and NCT03013595) with clusters allocated 1:2 between MT and UC. Recruitment took place in 40 CAMHS (eight European countries) between October 2015 and December 2016. Eligible participants were CAMHS service users who were receiving treatment or had a diagnosed mental disorder, had an IQ ⩾ 70 and were within 1 year of reaching the SB. MT was a multi-component intervention that included CAMHS training, systematic identification of YP approaching SB, a structured assessment (Transition Readiness and Appropriateness Measure) and sharing of information between CAMHS and adult mental health services. The primary outcome was HoNOSCA (Health of the Nation Outcome Scale for Children and Adolescents) score 15-months post-entry to the trial. RESULTS: The mean difference in HoNOSCA scores between the MT and UC arms at 15 months was -1.11 points (95% confidence interval -2.07 to -0.14, p = 0.03). The cost of delivering the intervention was relatively modest (€17-€65 per service user). CONCLUSIONS: MT led to improved mental health of YP after the SB but the magnitude of the effect was small. The intervention can be implemented at low cost and form part of planned and purposeful transitional care.

Addendum to the consensus opinion from the International Deep Endometriosis Analysis (IDEA) group: sonographic evaluation of the parametrium.

Preoperative sonographic staging in patients with suspected parametrial endometriosis is essential to plan the surgical intervention and to anticipate the need for a multidisciplinary approach, and hence optimize surgical outcome. The results of a recent metanalysis suggest that defining more accurately the ultrasonographic criteria of parametrial involvement in endometriosis is needed. The aim of this addendum to the IDEA-consensus is to highlight the sonographic characteristics of the parametrium and identify ultrasound techniques to diagnose deep endometriosis in this area. This article is protected by copyright. All rights reserved.

Future of TABST and LABST in the Indian Pharmacopoeia Monographs A Humane Society International/India Workshop Report.

Humane Society International India (HSI India) organized and facilitated a workshop on the 'Future of Target Animal Batch Safety Test (TABST) and Laboratory Animal Batch Safety Test (LABST) in the Indian Pharmacopoeia (IP) Monographs'. The workshop hosted key Indian regulators from the Indian Pharmacopoeia Commission (IPC) and the Central Drugs Standard Control Organization (CDSCO), industry representatives from the Indian Federation of Animal Health Companies (INFAH), Asian Animal Health Association (AAHA), and international experts representing the European Directorate for the Quality of Medicines (EDQM), the International Cooperation on Harmonization of Technical Requirements for Registration of Veterinary Medicinal Products (VICH), and multinational veterinary products manufacturers. The workshop was organized to encourage a bidirectional flow of information and to discuss the deletion of TABST and LABST from the veterinary vaccine monographs in the IP. This workshop was built from the symposium held by Humane Society International on the 'Global Harmonization of Vaccine Testing Requirements' held in 2019. This report details the outcomes of the workshop with proposed activities to be taken up as part of the next steps for the elimination or waiving of these tests.

Is there a ubiquitous association between sleep disorder and frailty? findings from LASI (2017-18).

BACKGROUND: Relatively little is known about how sleep disorders affect frailty of seniors. The study uses Fried's frailty index, to investigate the relationship between sleep disorder and frailty among older Indian adults. METHODS: The study analysed Longitudinal Ageing Study in India (2017-18) data which uses a multistage stratified area probability cluster sampling design. The association between frailty was studied for which the total sample size was 31,902. The principal dependent variable was frailty. Descriptive statistics and cross-tabulation were presented in the study. A binary logistic regression analysis was used to fulfil the study objectives to find the possible association. RESULTS: The prevalence of frailty in India was 21.3 percent. Older adults with sleep disorder had 66 percent higher likelihood to be frail than their counterparts. The benefits of physical activity in containing frailty is huge, the association were quite high. Poor Self-rated health was significantly associated with higher frailty (OR = 1.73; CI = 1.47-2.04). CONCLUSIONS: Frailty is an enormously growing public health issue and has bi-directional relation with sleep disorders. The study has clinical relevance since sleep complaints offer a means for identifying those who are vulnerable to frailty and through appropriate intervention, the causes of sleep disorder would help to delay and in some cases reverse frailty.